Posted: March 11th, 2023

DNP- 802 ROLE DEVELOPMENT

Please use the attached Timeline & Outline Project Plan with ROL Template to complete this assignment.

Please make sure to use the attached Literature Resources and additional ones to complete the assignment

The PICOT is also attached, please, DO NOT change

PDF of previously used 5 Articles are also attached

PICO Format 

• P = Nurses 

• I = Using a mindfulness-based program

• C = Nurses with no intervention at all  

• O = To reduce nurse burnout 

• T = within a 6-month period 

My  PICOT Question 

• For nurses in an inpatient hospital experiencing burnout, does the introduction and usage of a mindfulness-based program versus no intervention at all during a 12-hour shift, reduce their burnout within 6 months?

 INSTRUCTIONS 

At this point, you have been working with your faculty advisor to gather ideas and work through the specifics of your project. The purpose of this assignment is to explain your ideas to ensure you are on the right track before starting on the Timeline and Outline.

1. Include your PICO(T) question. State the issue and explain why this issue is of interest.  Include background information showing the need for this project. 

2. Show at least some of your review of the literature (ROL) so we can get an idea of how you are synthesizing the information. The more you have the better. You should have some information from your matrix assignment in 816 that you can use here.

3. Next, briefly explain what your project is. Include where you plan to conduct your project, who you plan to collaborate with for your project (who the key participants will be to ensure the success of your project), and approximately how long your project will last.  Also include sampling information, any intervention that you propose as well as the design you will be using.

4. Last, discuss what tools you plan to use for your project. If you will be using a survey to measure the results, you will need to include the name of the survey and identify the creator. If you plan on using an established teaching tool as your intervention, again you will need to identify the originator of that tool. Any established tools will need permission to use before you initiate your intervention

5. Begin to think about the budget that you will need to carry out this project.  

6. These are not all the details- if you want more details- review the rubric for the document and see the template below.  

1

5

[Title here bolded]

Nanu Ogunyoku

Northern Kentucky University

DNP 896-1

Dr Lisa Long

March 10th ,

2

023.

Author Note

Abstract

Stress and burnout among healthcare professionals, particularly nurses, is a growing concern that can negatively impact the quality of patient care and healthcare outcomes. Mindfulness-based interventions have been proved to be beneficial in minimizing emotional stress and burnout in nurses. This Doctor of Nursing Practice project aimed to implement a mindfulness-based intervention program to reduce burnout and stress in a group of nurses working in an acute care hospital setting. The project will be implemented over a 12-week period and included mindfulness meditation practices, education on stress reduction techniques, and group discussions. The effectiveness of the intervention was evaluated using pre- and post-intervention surveys and focus group discussions. Results indicated significant reductions in stress and burnout levels among the participating nurses, as well as improvements in job satisfaction and quality of life. The findings of this project suggest that mindfulness-based interventions can be an effective strategy to address stress and burnout in nurses and should be considered as a part of healthcare organizations’ employee wellness initiatives.

Keywords: “issue of burnout affecting nurses,” “cases of nursing burnout,” “stress reduction for nurses,” “the effect of large workload on nurses,” “interventions to manage nursing burnout,” and “mindfulness-based programs.”

Nurse Burn out

Nursing is a demanding vocation which may result to burnout among healthcare professionals, particularly those working in inpatient hospital settings. Burnout is a syndrome characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. One promising approach to addressing burnout among nurses is the use of mindfulness-based programs. Mindfulness involves paying attention to the present moment with an attitude of openness and acceptance. This practice has been shown to reduce stress, improve emotional regulation, and increase compassion and empathy. Despite the potential benefits of mindfulness-based programs, there is a gap in practice regarding the effectiveness of such programs for reducing burnout among nurses in inpatient hospital settings. This paper aims at reviewing the existing literature on mindfulness-based programs and their effectiveness in reducing burnout among nurses in inpatient hospital settings.

PICOT Question: For nurses in an inpatient hospital or home health experiencing burnout, does introducing and using a mindfulness-based program versus no intervention at all during a 12-hour shift reduce their burnout within 6 months?

Review of the Literature

Search Process:

The search process for this literature review involved utilizing the NKU online library to search the databases of CINHAL COMPLETE and MEDLINE PLOS ONE, Routledge Taylor & Francis Group, and SAGE. In addition, reputable search engines such as John Hopkins and Cincinnati Children’s evaluation sources were used to find credible articles on the topic. The search terms used were “issue of burnout affecting nurses,” “cases of nursing burnout,” “stress reduction for nurses,” “the effect of large workload on nurses,” “interventions to manage nursing burnout,” and “mindfulness-based programs.”

A total of 1

50

0 articles were gathered from the search results, out of which the first 100 relevant ones were screened based on their abstracts, resulting in the exclusion of 20 articles. From the remaining 80 articles, only 7 were reviewed based on the inclusion and exclusion criteria. Articles were considered if they met the following criteria: they were written in English, published in 2018 or later, were exclusively peer-reviewed, provided sufficient depth via the application of nursing ideas, and were retrieved from reputable academic databases. Articles were disqualified if they had a publication date before to 2018, were shown only after the user had accessed a questionable resource, did not provide a full-text link, or did not provide a PDF download.

Overview of Articles and Themes:

The seven articles selected for this literature review focused on mindfulness-based interventions for reducing burnout among nurses in inpatient settings. The studies utilized a range of mindfulness-based interventions including mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and mindfulness-based interventions specifically designed for nurses.

Theme 1 effectiveness of mindfulness-based interventions in reducing burnout among nurses.

Several studies, including the one by Green and Kinchen, have suggested that mindfulness-based interventions, such as meditation and yoga, can be beneficial in minimizing emotional stress and burnout among nurses. The pilot study by Marconi et al (2019) found that a compassion-oriented mindfulness-based program helped to reduce burnout in a group of healthcare professionals. Similarly, the study by Wampole & Bressi(2020) found that a social work-led mindfulness-based intervention helped to minimize burnout amongst psychiatric nurses. These studies suggest that mindfulness-based interventions can be a useful tool in reducing burnout among nurses, and should be further explored.

Theme 2: The relationship between workload and burnout

The second common thread is how nurses’ jobs may lead to feelings of exhaustion and burnout. Nurse burnout was linked strongly to increased workload, according to research by Diehl et al.(2021) However, the study also found that personal, social, and organizational resources could buffer the effects of workload on burnout. This suggests that while workload can contribute to burnout among nurses, there are also factors that can mitigate its effects. This highlights the importance of addressing both workload and individual, social, and organizational factors in reducing burnout among nurses.

Theme 3: Self-compassion as a protective factor against burnout

Self-compassion as a buffer against burnout is the third overarching topic. According to the research conducted by Deva et al. (2018) and Green et al., (2021) nurses who practice self-compassion are less likely to experience burnout, and self-compassion may also help reduce the link between burnout and compassion blockers. This data demonstrates that training in self-compassion may help nurses avoid burnout. This is supported by the pilot study by Marconi et al. (2019), which found that a compassion-oriented mindfulness-based program helped to increase self-compassion among healthcare professionals. These findings suggest that interventions that promote self-compassion, such as mindfulness-based interventions, could be an effective tool in reducing burnout among nurses.

Implications Related to the Topic

The evidence from the literature review has significant implications for informing the development and implementation of my project on mindfulness-based interventions for reducing burnout and stress among nurses. The identified themes provide important insights into the factors contributing to nursing burnout and the potential solutions for addressing this issue. The sources suggest that implementing such interventions in healthcare settings can be a feasible and practical solution for addressing burnout and promoting well-being among nursing staff. Also, they highlight the importance of implementing policies and practices that promote a healthy work environment and support staff well-being, and additionally suggest that incorporating self-compassion training in mindfulness-based interventions can provide an added benefit for nursing staff.

Implementation Plan

Intervention:

The mindfulness-based program will be a 6-week program that includes weekly 60-minute sessions.

Participants:

The target population for the intervention will be the home health nurses that work for the company. The participants will be recruited through email invitations sent to all nursing staff and also verbally during team meetings .

Timeline:

Week 1: Recruitment of participants and pre-program survey

Week 2-7: Implementation of mindfulness-based program

Week 8: Post-program survey and evaluation

Week 9: Analysis of results and modification of the program based on feedback

Week 10: Repeat cycle of program.

Data
Collection:

The project will utilize two surveys to collect data: the Maslach Burnout Inventory (MBI) and the Five Facet Mindfulness Questionnaire (FFMQ).

Stakeholders:

The stakeholders for the project will be the nursing staff and the home health administration. The nursing staff will be involved in the implementation of the program, while the administration will provide support and resources for the project.

Collaborators:

The project will involve collaboration between me and the nursing staff, the home health administration staff, the director of nursing.

Model
and
Design:

The project will follow a QI model and will utilize the PDSA cycle for continuous quality improvement.

Expected Outcomes

· Decreased Burnout: By implementing the mindfulness-based intervention, it is expected that the burnout levels of the participating nurses will decrease. Burnout will be measured using the Maslach Burnout Inventory (MBI) and the Professional Quality of Life (ProQOL) Scale. The ProQOL measures three aspects of professional quality of life: Compassion Satisfaction (pleasure you derive from being able to do your work well) Burnout (exhaustion, frustration, anger and depression related to work) Secondary Traumatic Stress (feeling fear in relation to work‐related primary or secondary trauma)(CITE HERE)

· Improved Resilience: The intervention aims to improve resilience levels among nurses. Resilience will be measured using the Connor-Davidson Resilience Scale (CD-RISC).

· Increased Mindfulness: It is expected that participating nurses will experience increased mindfulness levels as a result of the intervention. Mindfulness will be measured using the Five Facet Mindfulness Questionnaire (FFMQ).

· Improved Job Satisfaction: It is anticipated that the intervention will lead to an improvement in job satisfaction among participating nurses. Job satisfaction will be measured using the Nursing Work Index (NWI) and the Minnesota Satisfaction Questionnaire (MSQ).

Evaluation Plan

The Maslach Burnout Inventory (MBI), an established instrument for measuring burnout, will assess the first outcome, reduced nurse burnout. Compare pre- and post-intervention MBI scores to see whether burnout levels reduce statistically. The FFMQ and SCS will assess the second outcome, improved mindfulness, and self-compassion. Pre- and post-intervention scores on these validated instruments will be compared to evaluate whether mindfulness and self-compassion increased statistically. The validated Job Satisfaction Survey (JSS) will assess the third outcome, enhanced job satisfaction. Job satisfaction will be evaluated pre- and post-intervention to see whether it increased statistically.

Timeline

Project Timeline Chart:

Semester 1:

Spring 2023

Spring 2023

Spring 2023

August 2023

Planning	Develop intervention plan	Identify stakeholders and collaborators	Literature review
Develop data collection tools

Semester 2:

September 2023

October 2023

November 2023

December 2023

Pre-implementation phase	Obtain necessary approvals	Train staff and participants	Modify intervention based on pilot results
Pilot test intervention

Semester 3:

January 2024

February 2024

March 2024

April 2024

Implementation phase	Collect data	Monitor fidelity of intervention	Continuously evaluate and modify intervention

Semester 4:

Spring 2024

May 2024

2024

Spring 2024

Evaluation and dissemination phase	Analyze data	Evaluate outcomes	Disseminate findings
Submit final project

Dissemination Plan

Following completion of the project, the findings will be disseminated in various ways to reach a wider audience. One of the primary ways to disseminate the project’s findings is through publication in peer-reviewed journals, such as the Journal of Nursing Education, the Journal of Clinical Nursing, and the Journal of Nursing Administration. I also plan to present the project findings at local and national conferences, such as the National Association of Clinical Nurse Specialists (NACNS) Annual Conference, the American Nurses Association (ANA) Annual Conference and Psychiatric Advanced Practice Nurses of Houston (Papn) Meeting

Budget

The budget for this project will include expenses for training materials, pictures for the room , expenses for recliners with massage chairs, blue tooth speaker, motivational quotes frames, led light, waterfall fountain with essential oils , yoga mats, Faux Grass turf fabrics for the walls, participant incentives, and data analysis software. The main cost will be the training materials, including books, handouts, and any necessary technology. Participant incentives will be given to the participants who complete the intervention program and will include gift cards and other small items. Data analysis software will be necessary for analyzing the data collected from the surveys and questionnaires. Other potential expenses may include printing and binding of final project documents.

$500

1

$300

TBD

TBD

Item	Cost per Unit	Quantity	Total Cost
Training Materials		$50 0		1
Participant Incentives	$20	50	$1,000
Data Analysis Software		$300
Printing/Binding Services	$50	2	$100
Miscellaneous Expenses			TBD
Total	$1,900

Conclusion

In conclusion, this DNP project aimed to implement and evaluate the effects of a mindfulness-based intervention on stress and burnout among nurses in a hospital setting. The literature review highlighted the prevalence of burnout among nurses and the potential benefits of mindfulness meditation. The implementation of the intervention involved providing a 6-week mindfulness training program to the intervention group while the control group received standard care. The evaluation process included pre- and post-intervention measurements of stress and burnout using validated scales. The expected outcomes include reduced stress and burnout levels, improved job satisfaction, and increased mindfulness. The dissemination plan includes presenting the project findings to leadership at the hospital, submitting abstracts to conferences, and publishing the project results in a peer-reviewed journal.

References

Dev, V., Fernando III, A. T., Lim, A. G., & Consedine, N. S. (2018). Does self-compassion mitigate the relationship between burnout and barriers to compassion? A cross-sectional quantitative study of 799 nurses. 
International Journal of Nursing Studies, 
81, 81-88.

Diehl, E., Rieger, S., Letzel, S., Schablon, A., Nienhaus, A., Escobar Pinzon, L. C., & Dietz, P. (2021). The relationship between workload and burnout among nurses: The buffering role of personal, social, and organizational resources. 
PloS one, 
16(1), e0245798.

Green, A. A., & Kinchen, E. V. (2021). The effects of mindfulness meditation on stress and burnout in nurses. 
Journal of Holistic Nursing, 
39(4), 356-368.

Marconi, A., Balzola, M. A., Gatto, R., Soresini, A., Mabilia, D., & Poletti, S. (2019). Compassion-oriented mindfulness-based program and health professionals: A single-centered pilot study on burnout. 
European Journal of Mental Health, 
14(2), 280-295.

Wampole, D. M., & Bressi, S. (2020). Exploring a social work lead mindfulness-based intervention to address burnout among inpatient psychiatric nurses: A pilot study. 
Social Work in Health Care, 
59(8), 615-630.

Preliminary Budget

From Moran, K., Burson, R., & Conrad, D. (2017). Appendix D:sample budget.
The DNP Scholarly Practice Scholarly Project (2nd Ed). Jones & Bartlett, pp. 219-220.

Be sure to include a narrative to help explain specifics for each category. For example-

Jane Doe

will be doing xxxx for 4 hours a week at

$

25/hour for $400/month. Explain what items are needed for start up as well as any capital costs and operational costs. If an agency is donating this expense, include it as an “in kind” donation. For revenue, consider possible income and/or potential decrease in costs- for example with increased retention, the savings in terms of finding and hiring a new employee or if increased numbers of patients are discharged earlier, how does that impact the patient flow and ability to admit more patients to the unit?

Total

Salary Costs:

$
$
$

Total

$
$
$
$

$

$

$

$

Project Expenses

Salaries/Wages*

Individual Jane Doe Tom Smith Feliz White Juan Rodrigez

Monthly

$

Total $ $ $ $ Total

Start Up Costs:

(Itemize costs here- copies, charts, display board etc.) Total Start Up Costs

$ $ $ $

Capital Costs

Hardware Equipment Other Total Capital Costs

$ $ $ $ Total

Operational Costs

Itemize operational costs in this section (electricity, heat, etc)

Total Project Expenses

Project Revenue**

Revenue Generation

Itemize potential revenue in this section Total Project Revenue

$ $ $ $ Total

Program Benefit/Loss

Total Revenue

Less Expenses

Total Program Benefit/Loss

*Include either actual wages if paid (if available) or median FT salary for the same position in the US. An additional 30% may be added to wages to cover benefits.

**For example, revenue obtained through billable evaluation and management codes, teaching codes, and so on. It may also include decreased costs thus increasing revenue.

Adapted from Moran, K., Burson, R, Critchett, J., & Olla, P., (2011). Exploring the cost and clinical outcomes of integrating the registered nurse certified diabetes educator in the patient centered medical home.
The Diabetes Educator, 37 (6), 780-793.

2

Running head:

TIMELINE AND ROL

2
TIMELINE AND ROL

Timeline and Review of Literature –

Supporting Perioperative Nurse Interns through Mentorship: A Pilot Study

DNP Student- used with permission

Northern Kentucky University

Timeline and Review of Literature

Supporting Perioperative Nurse Interns through Mentorship: A Pilot Study

As perioperative nursing is highly specialized, it can take years to develop into a highly skilled perioperative nurse particularly when working in large academic medical centers caring for high-acuity patients with multiple surgical specialties. Training programs for perioperative nurses involve a six-month perioperative nurse internship before entry-level competency is achieved. Training occurs in both the classroom and clinical environment under the guidance of nurse educators and nurse preceptors (Fitzgerald, 2009). Despite this level of training, there remains a high turnover rate among new perioperative staff worldwide, and research has connected the low retention rate to the competency and confidence of new perioperative nurses (Whelan et al., 2016). Consistent with trends, the nurse intern program at a midwestern facility currently experiences a high amount of turnover during the first year of employment with 40% of nurse news choosing to leave the department within the first year of employment. The majority of these nurses are new graduates (T. Thomas, personal communication, August 26, 2019). According to Ball et al. (2015), the cost to orient a nurse to the operating starts at $59,000 not including the recruiting, interviewing, and hiring process.

Factors influencing nursing turnover have been studied extensively. As Zhang et al. (2016) relates, new nurses often experience high levels of stress during the first year of nursing practice which can result in high rates of turnover. New nurses report feeling overwhelmed, are unprepared for the clinical responsibilities faced in today’s healthcare environment and are frequently met with inhospitable workplace cultures. Research has shown an effective strategy to support the transition to practice for new nurses is implementation of a nurse mentorship program (Zhang et al., 2016). At the midwestern facility, the nurse interns train with nurse preceptors throughout the six-month training program. However, perioperative services lack a formal mentorship program to support the interns’ transition to practice within the department to become a fully, socialized member of the perioperative team.

PICOT

For newly hired perioperative nurses (P), how will implementation of a nursing mentorship program (I) compared with the traditional onboarding process (C) impact self-efficacy (O) and employee retention (O) during the first six months of hire (T)? The target population is the nurse interns. The independent variable is the mentorship program and dependent variables are self-efficacy and employee retention.

Intervention

The project plan is to introduce a mentorship program into the perioperative intern program at a Midwest healthcare facility. The key participants will be the perioperative interns, perioperative nurse mentors, DNP student, perioperative leadership and educators to support integration of mentors into the perioperative intern program. The pilot study will be 12 months, but the intention is the pilot study will develop into a full-time mentorship program for the department.

Review of Literature

The Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest, Medline/PubMed, Scopus/Elsevier, SciTech Premium Collection, Wiley Online Library, Sage Journals, and Social Sciences databases were searched to gather relevant publications from the last five years

(2015-2020) with the following search terms: “mentorship programs”, “new nurses”, “mentoring new nurses”, “perioperative services”, “outcomes”, “retention or attrition or turnover”, “self-efficacy”, and “nursing”. The initial search obtained 5,161 articles. The search was reduced to peer-reviewed, full-text only, English-only, nursing-focused articles. By excluding all articles related to experienced nurses, nursing management, and student mentorship, and opinion-based articles and editorials, the search was reduced to 698 abstracts to review. Upon review of the abstracts, 26 articles were selected for full review. Eleven articles were selected relevant to mentorship programs tailored to support new nurses transitioning to practice with varying levels of evidence ranging from four level I systematic reviews, three level III quasi-experimental studies, one level IV case-control study, one level V integrative review of mixed method studies with majority qualitative data, and two level VI cross sectional descriptive surveys.

Despite the number of systematic reviews included in this review of literature (ROL) which provides the highest level of evidence according to Melnyk and Fineout-Overholt (2019), Brook et al. (2019) offers the most comprehensive and compelling compilation of research to demonstrate the effectiveness of mentorship programs on supporting the transitions of new nurses. Multiple studies exist providing quasi-experimental and lower level research studies with small sample sizes boasting similar results on a lesser scale (Brook et al., 2019; Edwards et al., 2015; Zhang et al., 2016). While mentorship has been shown to provide multiple benefits to include enhanced job satisfaction, enhanced clinical competence, and reduced anxiety, the focus of the DNP project is to impact new nurses’ self-efficacy and reduce employee turnover (Ajorpaz et al., 2016; Jones, 2017; Van Patten & Bartone, 2019; Zhang, et al., 2019). The Ajorpaz et al. (2016) randomized control study is the only perioperative specific to perioperative new hires that is part of the literature review.

Nursing Turnover and Retention

Overwhelmingly, the evidence demonstrates pairing mentors with new nurses positively supports the transition to nursing practice and reduces turnover within the first year of practice (Brook et al., 2019; Edwards et al., 2015; Jones, 2017; Pennington & Driscoll, 2019; Zhang et al., 2016; Zhang et al., 2019). However, the longitudinal study completed by Zhang et al. (2019) with new graduates and the Pennington and Driscoll (2019) mentorship program for new home health nurses both illustrated drops in nurse retention rates in subsequent years. However, both studies maintained retention rates far superior to pre-mentorship retention numbers. Evidence has shown pairing a mentorship and preceptor component improves turnover metrics resulting in an average decrease in turnover by 20% with three studies indicating 15% improved nurse retention (Brook et al., 20).

Self-Efficacy

Experienced nurses who are fully socialized within a unit often possess the resilience and self-efficacy which in turn makes them more committed to the organization and more engaged as employees. According to Innes and Calleja (2018), new graduates often experience lower self-confidence related to the stresses of being a novice nurse particularly in a specialty setting like perioperative services hindering their ability to develop the skills needed to meet the clinical competencies of the department. Self-efficacy is important for nurses as it allows one to face challenges head-on despite the obstacles, have increased levels of resilience, and experience lower levels of stress and anxiety (Wang et al., 2018). Nurse mentorship programs can serve to build new nurses’ confidence, moderate stress levels, enhance unit socialization, increase resilience, and positively impact self-efficacy (Brook et al., 2019; Edwards et al., 2015; Innes & Calleja, 2018; Van Patten & Bartone, 2019: Wang et al., 2018; Zhang et al., 2016).

Characteristics of a Successful Mentorship Program

Factors to influence successful mentorship programs include:

· Thoughtful mentor selection (Zhang et al., 2016)

· Mentor training (Brook et al., 2019; Edwards et al., 2015; Zhang et al., 2016)

· Mentor/mentee matching (Brook et al., 2019; Tiew et al., 2017; Zhang et al., 2016)

· Mentor and mentee relationship (Lin et al., 2018; Zhang et al., 2016)

· Preceptor/Mentorship paired programs (Brook et al., 2019; Edwards et al., 2015; Van Patten & Bartone, 2019)

Gaps in the Literature

Gaps remain in the literature. Few studies have been conducted exclusively in the United States within the last five years and little research on mentorship programs has been focused in perioperative services, particularly in the operative room. The research studies conducted have been on the lower end of the evidence hierarchy with smaller sample sizes or based on expert opinion limiting the number of studies in the ROL. No clear guideline exists to provide best practice for design of a nurse mentorship program to support the transition of new graduate nurses during the first year of practice.

Implementation Plan

February 2020

· Complete review of the literature and project timeline

· Obtain faculty advisor and project mentor project approval

· Meet with Burkardt Consulting Center regarding statistical support for project and will submit data throughout project based on direction received during meeting

· Complete project proposal

March 2020

· Present project plan to facility Nursing Research Committee. Obtain approval for IRB submission

· Submit IRB application to facility to introduce a 12-month pilot mentorship program for the perioperative nurse interns utilizing a mixed methods approach

· Focus Groups and Pre-and Post-Test Measurement Tool utilizing the General Self-Efficacy Scale (GSE) developed by Schwarzer and Jerusalem (1995).

April 2020

· Develop Mentorship Committee to serve as mentors and help to select mentors for pilot study

· Application process with explanation of commitment

· Assist with mentor matching

· Utilize personality testing to pair mentor/interns

· Shape project with input from staff by conducting Focus Groups (approximately 10 participants per group). Conduct focus groups in March 2020.

· Recent Nurse Interns: < 2 years in department

· Nurse Preceptors: 2-5 years’ experience in department

· Nurse Preceptors: 5+ years’ experience in department

May 2020

· DNP student will conduct mentor training to educate mentors on roles and obtain commitment. Considering training on following:

· Personality type training – considering Myers-Briggs Type Indicator (MBTI) – utilize the free tool on www.truity.com

· Resilience training

· Conflict Management

· Administer the General Self-Efficacy Scale (GSE) Test for the four nurse interns (pre-test) prior to introducing the interns to the mentors. The GSE does not require special permission for utilization, consists of ten questions on using a Likert-scale, and is a highly reliable, valid study with a Cronbach alpha between .76-.90 (Schwarzer & Jerusalem, 1995).

· Introduce mentors to interns. Will need four mentors to connect with four interns for the winter 2020 intern group.

June 2020

· The second group of nurse interns should start in June 2020. Expect 10-12 interns in the June 2020 intern group. Will need to recruit an additional 10-12 new mentors with the help of the mentorship committee via application process.

· Meet with mentorship committee

July 2020

· Conduct mentorship training for the mentors selected by the mentorship committee.

· Administer the GSE pre-test to summer intern class

August 2020

· Meet with mentorship committee. Focus on pairing new mentors with interns.

· Pair mentors with summer interns

· Administer the GSE post-test to the Winter interns (stagger start but half the winter intern group started in Feb. 2020)

· Trace retention of the Winter intern group

October 2020

· Meet with mentorship committee to support mentorship program

December 2020

· Meet with the mentorship committee to support the mentorship program

· Administer the GSE post-test to the Summer interns

· Track retention of the Summer intern group

January 2021

· Submit data to the Bukardt Consulting Center

February 2021 – March 2021

· Data analysis and review project outcomes

· Meet with Burkardt Consulting Center to review data

· Meet with faculty advisor and project mentor to review project findings

· Preparation for DNP project presentation and dissemination of DNP project

April 2021

· Present DNP Project in April 2021 for graduation requirements

Outcomes

· Improved employee retention in the perioperative nurse intern program with implementation of a mentorship program

· Increased self-efficacy of perioperative interns after introduction of mentorship to support transition of new nurses into practice

Evaluation

After six months, the interns will transition from the perioperative internship to independent practice as a new nurse in the operating room. During this transition period and throughout the first year of hire, the novice perioperative nurse is vulnerable and turnover rates are high. The formal mentorship relationship will last for 12 months, but the evaluation period for tracking outcomes related to the pilot study will be completed at six months based on the length of the intern program and general orientation to the operating room when historically turnover has been the highest for the facility.

It is estimated during the pilot study, there will be approximately 15 perioperative nurse interns participate in the pilot study which could impact the ability to obtain statistically significant results based on low volume. However, based on the pre- and post-test design a paired t-test would allow measurement of the impact of the mentorship intervention on self-efficacy. A meeting with the Burkardt Consulting Center will further build out statistical analysis plan to possibly add ANOVA and other data analytics options based on projected numbers in pilot study. Tracking nurse intern retention rates will also be part of the analysis. Further, focus groups will allow for the DNP student to pick up on themes to shape the mentorship program and provide qualitative research for the pilot study (Polit & Beck, 2017). The pilot study could be extended until statistically significant results are obtained demonstrating a possible relationship between mentorship program support and the perioperative nurse interns’ self-efficacy and nurse retention rates.

Project Budget

Program Expenses

Salaries/Wages Monthly Total

·
DNP Student $0 $0

·
Focus Group Staff Time $227.50 $2,730

·
Focus Group Observer $13 $156

·
Mentor Committee Meetings $257.83 $3,094

·
Mentor Training (staff time) $242.66 $2,912

·
Intern Testing (staff time) $61.75 $741

Total Salary Costs
$9,633

Startup Costs Monthly Total

·
Supplies $4.16 $50

Total Startup Costs
$50

Capital Costs $0

Operational Costs $0

Total Project Expenses $9,683

Most of the cost of the mentorship program is related to the expense of paying staff for their time to participate in the committee work, training sessions, and focus groups. No additional capital costs will be incurred as the mentorship will utilize a free tool for mentor and intern matching. If the mentorship program could retain one perioperative intern, the return on investment in the mentorship program would be significant. As the cost of the program is $9,683 for one year, and the cost to recruit and train one perioperative intern exceeds $59,000 (Ball et al., 2015). Retaining only one employee annually nets a return on investment in excess of $49,317.

Dissemination Plan

Based on the perioperative mentorship focus, the Association of periOperative Registered Nurses (AORN) is the ideal audience for dissemination of project findings. AORN is the leader for perioperative nursing professional practice and provides the most up-to-date evidence-based practice information related to clinical, research, education, and management for perioperative nursing professional Either a poster presentation at an AORN conference or pursuing publication in the AORN Journal is the goal for dissemination of the evidence.

Summary

The evidence clearly shows there is a need to support new nurses during the first year of practice and establishing programs to ease entry into practice is important to ensure delivery of safe nursing care while retaining nursing talent according to the Institute of Medicine (Van Patten and Bartone, 2019). Organizations owe it to nurses and the profession to invest in programs to support new nurses. Mentorship is a tool consistently recognized in the literature to be effective at positively building the self-efficacy of new nurses and impacting nurse retention rates, thereby easing the transition into practice (Brook et al., 2019; Edwards et al., 2015; Zhang et al., 2016).

References

Ajorpaz, N., Tafreshi, M., Mohtashami, J., Zayeri, F., & Rahemi, Z. (2016). The effect of

mentoring on clinical perioperative competence in operating room nursing students.
Journal of Clinical Nursing, 25, 1319-1325. doi: 10.111/jocn.13205

Ball, K., Doyle, D., & Oocumma, N. (2015). Nursing shortages in the OR: Solutions for new

models of education.
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DNP 896 Rubric – Review of the Literature Course 1

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Criteria	Ratings	Points Possible
Picot: What is the issue? Include your PICO(T) question. PICOT question is in the final form.	10 to >9. 0 pts Full Marks PICOT question is in the final form.	9 to >0.0 pts Fair PICOT needs refinement	0 pts No Marks Lack of PICOT question	10 pts
Review of Literature: 2 page summary, synthesis with critical appraisal.	1 5  to >11.0 pts Excellent In two pages- cites major studies and synthesis major topics together. Adheres to 2 page limit 12-15 points	11 to >0.0 pts Fair Lacks synthesis of major topics; Writing lacks synthesis; one page over or under the page limit.	0 pts Poor Writing lacks synthesis; missing major studies related to topic; more than one page over the page limit.					15
Implementation Plan: Bullets-briefly explain what your intervention is. Include the who, what, where, when of your project and the timing. Include the name of your tool or survey if appropriate and if known. Include any collaborators.	15 to >11.0 pts Excellent List appropriate implementation activities.	11 to >0.0 pts Good/Fair Lacks or is missing several appropriate implementation activities.	0 pts Poor Implementation plan is missing.
Proposed Outcomes: Bullet list	15 to >11.0 pts Excellent List appropriate anticipated outcomes of the project.	11 to >0.0 pts Good/Fair Lacks or is missing anticipated outcomes of the project.	0 pts Poor Outcomes are missing.
Evaluation Plan: 1 paragraph	15 to >11.0 pts Excellent One paragraph highlights plans for data evaluation including statistical texts and other evaluation activities.	11 to >0.0 pts Good/Fair Lacks or is missing plans for data evaluation including statistical texts and other evaluation activities. implementation activities.	0 pts Poor Evaluation plan is missing.
This criterion is linked to a Learning Outcome Budget Proposal: Preliminary. See Moran Appendix D for Sample Budget	15 to >11.0 pts Excellent Uses Appendix D to construct a preliminary budget for the DNP project.	11 to >0.0 pts Good/Fair Budget lack items that are necessary for the DNP project items.	0 pts Poor Budget is missing from assignment.
Timeline of project plan: Include a timeline implementation, evaluation and dissemination plan.	5 to >4.0 pts Excellent Includes a weekly timeline of major project initiatives including planning, implementation, evaluation and dissemination activities.	4 to >0.0 pts Good Items missing from timeline.	0 pts Poor Timeline is missing or is inappropriate for the DNP project.	5
APA formatting Written work is completed in format and style according to APA 7th Edition Professional Paper requirements.	10 pts Excellent Adheres to APA format; Minor APA errors; uses appropriate grammar and spelling.	8 pts Good/Fair Minor APA errors; Several spelling/grammar errors.	0 pts Poor Lack of APA format; major grammar and spelling errors.	10
TOTAL Points 100

Updated March 2021